A wide variety of processes involve the employment of devices in close proximity to fragile or easily damaged or injured structures. Many medical and/or surgical procedures fall into this classification. For example, it is a common occurrence during surgery to contact unintentionally a structure other than intended. Such contact could result in or contribute to injury or damage to the contacted structure. This injury or damage may decrease the likelihood of success of a procedure, increase a patient's chance of death or continued illness, cause pain, delay recovery, prolong the duration of a procedure, and/or other undesirable results.
One particular example is bladder injury that may occur with antiincontinence and/or other surgery, and especially when needles are used to pass sutures and/or sling material from the vagina to the suprapubic region, or vice versa. In the popular Tension-free Vaginal Tape (TVT) procedure, inadvertent bladder injury may occur. This type of injury can be minor but could also result in some or all of the serious sequelae enumerated above. The chances of minimizing the injury are improved if the injury is recognized intraoperatively, so that the needle can be replaced in a slightly more lateral position. Repositioning typically requires intraoperative cystoscopy after filling the bladder with a sufficient amount of distention fluid, usually 300 cc of water or normal saline. Failure to visualize the bladder carefully or to fill the bladder sufficiently may lead to failure to recognize a bladder injury, which may result from placing needles, suture or sling material intravesically (in the bladder). This may lead to recurrent urinary tract infections, hematuria or stone formation. In addition, some qualified gynecologic surgeons do not have cystoscopy privileges at their hospitals, which prevent them from performing these procedures.
The art would be enhanced by the provision of systems and methods to help prevent and detect damage to tissues. In particular, the art would be enhanced by the provision of systems and methods that facilitate non-cystoscopic evaluation of bladder injury during antiincontinence surgery.